The Pharmacare paradox

I found this story surprising -- B.C. really does have one of the most comprehensive government drug plans in Canada, so why would residents be most likely to report being unable to afford their prescriptions?

In the article, Andrew MacLeod outlines one explanation -- coverage may be wonderful for people with no income, but for lower-earning workers, deductibles and family maximums are still high. An extra $75-$100/month for a family earning $30,000/year is a significant expense.

(NOTE that the article refers to individual income, but the income brackets and deductibles are the same for families; also note that there is a deductible, under which you pay full cost and above which you pay 30% co-payment, as well as a higher maximum annual payment.)

But that alone doesn't explain why B.C. residents are more likely to complain of the expense than those in provinces with no public pharmacare at all.

So, some other possible explanations:

Are B.C. employers less likely to offer private pharmacare because they feel the government already covers it?

Are there still a significant proportion of B.C. residents who are not registered for Pharmacare, or who are currently uneligible, for example because they are not up-to-date with their tax returns?

Is the use of an annual deductible and maximum payment cap a barrier for residents whose income is very much month-to-month? I believe Pharmacare has special programs for short-term need, but again this is more paperwork and people aren't always told help is available. And while it might make sense to average out prescription costs over the year for sporadic problems, when the medications are for chronic illness, monthly deductibles would make it easier for people to budget.

NOT TAKING MEDICATIONS!

I have commented in the past on this item. Income is not the best measure, the cost for basic food has gone up in the last 10 years. The Government says we have the lowest income tax, what they do not say is that is only the BC income tax, more taxes have been added, the HST for one. Medicare premiums have been increased since 2001, BC is the only province in Canada that charges it's residents MSP premiums. For the working poor that are maybe $100.00 over the limit for a subsidy for BC MEDICARE. The HST is paid on deposit for a drink container, you get the deposit back if you recycle but not the HST tax. There is also the cost of accommodation - do I pay the rent? Do I pay the utilities? Do I buy food? How about proper clothing? Meds are the first to go when decisions are made. WE MAY PAY THE LOWEST BC INCOME TAX AND THE LOWEST CORPORATE TAX but the lower income wage earners are being taxed to death by the BC Government downloading costs onto Cities and Municipalities.

cash cow

Some drug stores charge far more than others. The governement has stopped doctors from givng out some drugs used for pain. For very poor people some drug stores sell medications at cost or less using it as a tax write off. Not many kind people in the world any more. Our government treats BC'ers like cash cows- some seem to get shafted until they die of starvation or NOW the cold would do it. Today having basic welfare giving a person the ability to share a room / unit and have food would be a great medication for the problems some are suffering from

Maybe Too Much Drug Consumption

I'd like to know which drugs are unaffordable. Statins (for high cholesterol) are one of the most prescribed drugs, along with various painkillers. Are statins really necessary? What about proper diet and exercise instead of popping pills. I'm sure much of the drugs are related to lifestyle-induced illnesses.
According to the story: "By age, the highest rate of non-adherence was among 35 to 44 year olds, with people over 65 most likely to be able to afford their drugs."
So, the group who are capable of controlling their health aren't taking prescriptions. Is this a case of people preferring easy solutions rather than relying on will power?

Many more imaginative possibilities...

Why not loosen up the patent protection for drug manufacturers? Better yet, allow the dispensing of a much larger portion of drugs by non-pharmacists' union members.

And end the Pharmacare subsidization scheme, which has had the same effect on drug prices that low interest rates have had on house prices : RAISING THEM.

surprising? I've heard it all now...

"Someone making under $15,000 a year pays two per cent of their income, or up to $300, before coverage kicks in to pay 70 per cent of the cost." Please read this sentence slowly and carefully. Now think on this: the median rent in BC is $800/month, or $9,600/year. (That is outside of Vancouver, where it is much higher.) Add utilities, phone, food. WTF is left over for prescriptions? Before coverage kicks in? I suppose it would be pointless to mention the homeless...

I am one of those who have stopped taking a prescription because of no money to purchase it. I am not looking for sympathy, but the fact that you can't see that the problem exists is where our real problem lies. Over and over again I hear from those who are managing to pay the bills that we have a social safety net, dontcha know. We DONT. Observe the welfare rates, observe the growing numbers of homeless and the high rate of child poverty, and the high rate of unemployment and underemployment, and the lack of affordable housing...just observe.And maybe do a litle math.

BC versus Quebec and Ontario..

Quebec and Ontario pay 40% less for generic drugs than British Columbia.

If BC had the same deal as those provinces the savings per year would amount to $157 million dollars(That number will rise with BC`s growing and aging population)

Gordon Campbell gifted big Pharma before he left for London.

Right with corporate pigs like the BC Liberals, who are run by Corporate, sponsored by corporate animals like Patrick Kinsella and gywn Moprgan are continuing transferring wealth from Public to corporate bottom lines!

Thanks BC Liberals

Free To Move

I know several families who couldn't afford to live in BC so they moved elsewhere, in particular Alberta where the benefits are more generous.

don't forget Mulroney's gift to big pharma

As outlined in "The Quick and the Dead: Brian Mulroney, Big Business and the Seduction of Canada" (Toronto: Penguin Books, 1991)
http://www.lindamcquaig.com/Books.cfm

Canada has one of the most aggressive generic drug policies

We have compulsory generic drug manufacture, with limited patent protection. Novopharm and Apotex were founded with government help to compete with brand drugs.

The Canadian provinces COULD buy all their drugs under one big contract, but the best way to do it would be through the feds, who already control manufacturing anyway.

Perhaps that would be the best federal healthcare contribution, to provide the drugs for he provinces, rather than funding the part of the whole healthcare program.

We do need to talk about limiting the free services offered under health care. Do we want to fund abortions, breast implants and plastic surgery, for example? How about coronary bypasses, prosthetic knees and hips?

Tommy Douglas probably couldn't even imagine some of the services we now offer for free. Is a two-tier system that bad? Is user-pay a good idea for optional services? We need to talk now before healthcare sucks up 75% of provincial GDP. Otherwise we won't be able to drive to hospital for all the potholes in the roads.

Sask is looking pretty good for retirement

Imagine no MSP premiums, no HST (hey got rid of it), a lower cost of living and their government still has some respect for the senior voters. Sask only has one big problem and that is the name is too long, not short like BC which means Bring Cash by the way.

BC once again dead last!!!!

Oh. I just reconfirmed Stats Can. BCers live longer than any other Canadians.

Maybe if we take more drugs like the rest of Canada we can catch them up and die younger.

"Cheaper Drugs! We want to croak early too"

This calls for a massive demonstration!

The Dunlop Enquiry in Britain, 1973

An enquiry was set up in Britain o ask the very same question: Why are some drugs so expensive, and what can be done about it?

One quip was: Why does tohe government want us to have cheap drugs anyway? Is it to keep us under cntrol?

We have wo problems here: one group of British Columbians are paying a fortune for Ecstasy andther drugs, while some of us can't afford prescription medication. The two groups ought to get together and figure it out.

I Just Heard an Interview With The Researcher

And he admitted they didn't know which drugs aren't being taken so really, this study is faulty and should not be used as any sort of talking point.
Incomplete data is being used for fear-mongering.

Ramona777

Niacin:
Niacin, a B vitamin, has long been used to increase high-density lipoprotein (HDL), or the "good," cholesterol. HDL cholesterol helps sweep up low-density lipoprotein (LDL), or the "bad," cholesterol, in your bloodstream. Although niacin is readily available and effective, it hasn't gotten much attention compared to other cholesterol drugs
http://www.mayoclinic.com/health/niacin/CL00036
While there is little doubt that exercise and diet are important, what is much more important is how we place our faith in institutions where keeping us sick keeps them in business.

And while we are at it:
http://dotsub.com/media/fc4e051a-1709-4e63-8a2c-912b09486c9f/e/m

R/M old man....

And your point being......?
http://www.vancouversun.com/news/Opinion+Retirement+dreams+slipping+away/5612648/story.html

fear mongering?

RickW and others raise important points about drugs, and the health care system in general. We spend less than 1% of the total health care budget on preventative medicine, when in fact we know that diet and excersize are the two of the three biggest contributors to overall health. (The other is genetics.)

It is not fear mongering to point out that the poor cost the health care system more in the long run: we have evidence that poor diets as well as other factors worsen health outcomes for lower-income people. It is not fear mongering to point out that what many take for granted simply can't be afforded by the poor. And it is not fear mongering to suggest that a reasonable and respectful social safety net would actually mean that ALL of us paid less taxes because of lower health care costs.

Anyway, there are hundreds, if not thousands of studies on these issues - not to mention a Royal Commission, wasn't it? - so nobody need take my word, or the authors' - one could simple gather the information. But I still am curious that no one cares to do the math on the lowest incomes in the province, and what drug costs mean...I was sent home from eye surgery with some antibiotic drops that ran out before the required course of treatment. To refill the prescription cost $150.00 which I did not have, so I did not complete the treatment. Fortunately no complications ensued...do you think this is a sensible use of pharmacare dollars? That I make a few thousand dollars yearly and have to pay for all my prescriptions in spite of my so-called coverage? (My prescriptions, which are few and far between, have never exceeded my deductible.) Of course my story is anecdotal, but as the article points out, the math suggests that there are more of me out there. The question that never gets answered is why the 'haves' have such difficulty in understanding the struggles of the 'have nots'. No understanding or empathy, apparently...I can hardly change that. But I can assert that my story, and the many others I know of, are not fear mongering.

The demographics should be considered in transfer payments

Of course the Alberta premier is going to demand a straight per capita payment. They have the youngest population in the country. BC and other provinces, have all the ex-Albertans (like me, for example) and we need more health care just because we are older.

For Albertans to ignore this is counter-productive; many of them are coming here in a few years anyway.

VivianLea ...

Your example of running out of antibiotic drugs is one, to me, of the totally valid use of prescription drugs. When antibiotics aren't taken as prescribed, we get resistant bacteria and then huge health-care problems.
I'm talking about people who prefer to abuse their health and then get Type 2 diabetes or heart conditions or those who get sucked into thinking a little pill will improve their low mood.
I'm supposed to be taking pills for arthritis. I refuse to, preferring to suffer through the pain rather than deal with several side effects.
When I referred to "fear mongering" I meant the release of an incomplete study that gets used to push a certain agenda.

So Perhaps Harper should take a page from his own notebook....

....and, like he did with daycare (with his laughable $100/month) simply allocate to each Canadian a fixed amount for medicare........

Once again, no one has mentioned the prescription fee.

The prescription fee used to be about $7.00 when I worked in the drug industry. I don't think it has changed much since then. Some of the cheaper medications cost pennies. Pharmacists sometimes made their profit by buying the drugs at discount, but charging the customer the full list price.

There are subtle costs involved in the healthcare industry. For one thing, I have to see my doctor every three to six months for a prescription renewal even though my meds have not changed in ten years. A call to the receptionist would be sufficient. It would not be optimal, but in my case it would suffice.

There are real potential savings in long term care facilities where the decision to treat elderly patients 'aggressively' produces no benefit. Some patients are on six or more meds per day, to the point where they interfere with one another.

Then there is the issue no one wants to talk about, the right to die. We keep many people alive well past the point where their lives are worth living. If the last two years of a person's life are the most expensive in terms of health care, why not give everyone the right to cash out their chips while they are still ahead of the game? I am talking euthanasia.

Granville

Blame the lawyers, and the kids who dump Mum 'n' Dad in some impersonal care institution, then sue, sue, sue when Mum 'n' Dad die..........